APACHEⅡ评分对静脉溶栓治疗的重症脑梗死患者病情评估的价值
Value of APACHE Ⅱ score in the evaluation of severe cerebral infarction patients with intravenous thrombolysis

白一蕾.APACHEⅡ评分对静脉溶栓治疗的重症脑梗死患者病情评估的价值[J].内科急危重症杂志,2021,27(2):135-137

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DOI：10.11768/nkjwzzzz20210212

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作者	单位	E-mail
白一蕾	新乡医学院开封市中心医院	kffzx2009@163.com

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中文摘要:

目的: 探讨急性生理与慢性健康状况评估（APACHEⅡ）评分对静脉溶栓治疗的重症脑梗死患者病情及预后的评估价值。方法: 收集80例经静脉溶栓治疗的重症脑梗死患者的临床资料，根据患者入院后4周内的生存状况将其分为生存组（59例）与死亡组（21例），比较2组间的 APACHEⅡ评分，采用受试者工作特征(ROC)曲线及曲线下面积（AUC）评估APACHEⅡ评分预测死亡的灵敏度、特异度和准确性，寻找APACHEⅡ评分的生存死亡最佳临界值，采用Hosmer Lemeshow拟合优度检验APACHEⅡ评分的可靠程度。结果:生存组与死亡组APACHEⅡ评分比较，差异有统计学意义\[（11.78±4.25）分 vs（23.14±4.74)分，P ＜0.01\]。APACHEⅡ评分预测死亡的AUC为 0.955，临界值为17分，敏感度为95.2%，特异度为89.7%；Hosmer Lemeshow拟合优度检验值提示有较好的校准能力（χ2=6.223， P= 0.514）。结论:APACHEⅡ评分对经静脉溶栓治疗的脑梗死患者病情的严重程度预测有较高准确性和可靠性。

英文摘要:

Objective: To study the applied value of APACHE Ⅱscore for cerebral infarction patients in NICU who have received venous thrombolytic therapy. Methods: The clinical data of 80 cerebral infarction patients who have received venous thrombolytic therapy from NICU were collected. The patients were divided into survival group (59 cases) and death group (21 cases) on the basis of their vital signs within four weeks of hospitalization and APACHE Ⅱ score was compared. The sensitivity, specificity and accuracy of APACHE Ⅱ score in predicting death were evaluated by the receiver operating characteristic (ROC) curves and the optimum critical value of APACHE Ⅱ score in judging people's vital signs was obtained. The reliability of APACHE Ⅱ score was evaluated by the method of Hosmer Lemeshow goodness-of-fit. Results: The APACHE Ⅱ score in survival group (11.78±4.25) and death group (23.14±4.74) showed significant differences between the two groups ( P <0.01). The area under the ROC curve (AUC) of APACHE Ⅱ score in predicting death was 0.955, meeting "high accuracy" in the standard of statistics. The optimum critical value of APACHE Ⅱ score was 17, with the sensitivity of 95.2% and specificity of 89.7%. The Hosmer Lemeshow goodness-of-fit indicated a preferable calibration ability (χ2= 6.223, P =0.514). Conclusion: For cerebral infarction patients in NICU who have received venous thrombolytic therapy, APACHE Ⅱ score has a satisfactory accuracy and reliability in predicting their condition.